Most Recent Articles
Oct 7, 2020
Gallagher Bassett: Audit Complaint Filed With DWC
In a previous article, we demonstrated how Gallagher Bassett ignores the California-mandated workers’ comp Official Medical Fee Schedule (OMFS). Gallagher Bassett also ignore...
Oct 15, 2020
Zurich: Triples Down on Foul Play
Clearly Zurich fears no recourse as it continues to systematically ignore rules while stripping California providers of proper reimbursement. In this latest development, Zuri...
Oct 20, 2020
When Zurich Speaks, Garbled Noncompliance Comes Out
We are writing about Zurich again, as the claims administrator’s conduct continues to be a symptom of the deep unfairness that permeates California’s workers’ comp system. Th...
Oct 21, 2020
DaisyBill Automates Zurich Second Review Appeals
DaisyBill recently broke the story (after receiving multiple reports from the DaisyBill community and beyond) that Zurich has improperly denied California providers’ bills fo...
Jan 27, 2021
Is ESIS Gaming California's Work Comp System?
In this latest installment of the IBR Hall of Shame, we chronicle the never-ending payment torture inflicted on a provider who “wins” an Independent Bill Review (IBR). This i...
Jan 28, 2021
ESIS & ABM Industries - IBR Hall of Shame
We continue to look at the misbehavior of ESIS, which yesterday entered the IBR Hall of Shame for its deplorable treatment of a provider who prevailed in two Independent Bill...
Mar 24, 2021
IBR Hall of Shame: Employers
Employers Holdings set a shameful new standard of indifference with regard to promptly and correctly reimbursing providers. The insurer incorrectly denied payment, disregarde...
Mar 30, 2021
Zurich Denies Liability After Accepting Liability
Zurich recently denied liability for an injured workers’ treatment, claiming the 2003 injury was not work-related — despite the fact that Zurich already authorized the treatm...
Apr 2, 2021
Broadspire Knows No Law But Its Own
Broadspire continues to break the rules, seemingly confident that California regulators will not hold the claims administrator to account. For months, we reported on B...
Apr 5, 2021
City & County of San Francisco's Misleading Reply PPO Dispute
Recently, a DaisyBill provider disputed a reduction in reimbursement from the City and County of San Francisco (CCSF) for treating an injured employee. In the Explanation of ...
Jun 4, 2021
Sedgwick Defies DWC COVID Rules; DWC Washes Hands
Sedgwick defied California workers’ comp regulations, costing a provider thousands in due reimbursement. Unfortunately, the Division of Workers’ Compensation (DWC) has declin...
Jun 28, 2021
CA DWC Lets SCIF Skirt IBR for Incorrect GPCI
In a baffling decision, the California Division of Workers’ Compensation (DWC) declared a straightforward billing dispute ineligible for Independent Bill Review (IBR) — despi...